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Clinical decision-making, knowledge support systems, and theory

Section edited by Paul Taylor

This section aims to publish studies on the development, implementation and evaluation of clinical decision support systems. The section also accepts articles on the theoretical support of clinical decision-making (including shared-decision making), decision analysis, and decision aids.

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  1. Thrombophilia testing is frequently ordered in the inpatient setting despite its limited impact on clinical decision-making and unreliable results in the setting of acute thrombosis or ongoing anticoagulation....

    Authors: Henry Kwang, Eric Mou, Ilana Richman, Andre Kumar, Caroline Berube, Rajani Kaimal, Neera Ahuja, Stephanie Harman, Tyler Johnson, Neil Shah, Ronald Witteles, Robert Harrington, Lisa Shieh and Jason Hom

    Citation: BMC Medical Informatics and Decision Making 2019 19:167

    Content type: Research article

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  2. Most breast cancer patients undergoing mastectomy are candidates for breast reconstruction. Deciding about breast reconstruction is complex and the preference-sensitive nature of this decision requires an appr...

    Authors: Jacqueline A. ter Stege, Leonie A. E. Woerdeman, Daniela E. E. Hahn, Martine A. van Huizum, Frederieke H. van Duijnhoven, Jacobien M. Kieffer, Valesca P. Retèl, Kerry A. Sherman, Arjen J. Witkamp, Hester S. A. Oldenburg and Eveline M. A. Bleiker

    Citation: BMC Medical Informatics and Decision Making 2019 19:165

    Content type: Study protocol

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  3. To understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes (T2D) care built on top of computeriz...

    Authors: Giuseppe Fico, Liss Hernanzez, Jorge Cancela, Arianna Dagliati, Lucia Sacchi, Antonio Martinez-Millana, Jorge Posada, Lidia Manero, Jose Verdú, Andrea Facchinetti, Manuel Ottaviano, Konstantia Zarkogianni, Konstantina Nikita, Leif Groop, Rafael Gabriel-Sanchez, Luca Chiovato…

    Citation: BMC Medical Informatics and Decision Making 2019 19:163

    Content type: Research article

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  4. There is growing interest in sensor-based assessment of upper limb tremor in multiple sclerosis and other movement disorders. However, previously such assessments have not been found to offer any improvement o...

    Authors: David G. Western, Simon A. Neild, Rosemary Jones and Angela Davies-Smith

    Citation: BMC Medical Informatics and Decision Making 2019 19:162

    Content type: Research article

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  5. Healthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the sev...

    Authors: Annemieke A. J. Konijnendijk, Magda M. Boere-Boonekamp, Maria E. Haasnoot and Ariana Need

    Citation: BMC Medical Informatics and Decision Making 2019 19:161

    Content type: Research article

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  6. Drug-drug interactions (DDIs) can cause patient harm. Between 46 and 90% of patients admitted to the Intensive Care Unit (ICU) are exposed to potential DDIs (pDDIs). This rate is twice as high as patients on g...

    Authors: T. Bakker, J. E. Klopotowska, S. Eslami, D. W. de Lange, R. van Marum, H. van der Sijs, E. de Jonge, D. A. Dongelmans, N. F. de Keizer and A. Abu-Hanna

    Citation: BMC Medical Informatics and Decision Making 2019 19:159

    Content type: Study protocol

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  7. Collective intelligence, facilitated by information technology or manual techniques, refers to the collective insight of groups working on a task and has the potential to generate more accurate information or ...

    Authors: Kate Radcliffe, Helena C. Lyson, Jill Barr-Walker and Urmimala Sarkar

    Citation: BMC Medical Informatics and Decision Making 2019 19:158

    Content type: Research article

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  8. Female BRCA1 and BRCA2 mutation carriers have an increased lifetime risk of developing breast and/or ovarian cancer. Hence, they face the difficult decision of choosing a preventive strategy such as risk-reducing...

    Authors: Lisa Krassuski, Vera Vennedey, Stephanie Stock and Sibylle Kautz-Freimuth

    Citation: BMC Medical Informatics and Decision Making 2019 19:154

    Content type: Research article

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  9. Although complex machine learning models are commonly outperforming the traditional simple interpretable models, clinicians find it hard to understand and trust these complex models due to the lack of intuitio...

    Authors: Radwa Elshawi, Mouaz H. Al-Mallah and Sherif Sakr

    Citation: BMC Medical Informatics and Decision Making 2019 19:146

    Content type: Research article

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  10. Approximately 20% of deaths in the US each year are attributable to smoking, yet current practices in the recording of this health risk in electronic health records (EHRs) have not led to discernable changes i...

    Authors: Ellen L. Palmer, John Higgins, Saeed Hassanpour, James Sargent, Christina M. Robinson, Jennifer A. Doherty and Tracy Onega

    Citation: BMC Medical Informatics and Decision Making 2019 19:143

    Content type: Research article

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    The Research article to this article has been published in BMC Medical Informatics and Decision Making 2019 19:141

  11. Usage of structured fields in Electronic Health Records (EHRs) to ascertain smoking history is important but fails in capturing the nuances of smoking behaviors. Knowledge of smoking behaviors, such as pack ye...

    Authors: Ellen L. Palmer, Saeed Hassanpour, John Higgins, Jennifer A. Doherty and Tracy Onega

    Citation: BMC Medical Informatics and Decision Making 2019 19:141

    Content type: Research article

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    The Research article to this article has been published in BMC Medical Informatics and Decision Making 2019 19:143

  12. Medication therapy management (MTM) is a service, most commonly provided by pharmacists, intended to identify and resolve medication therapy problems (MTPs) to enhance patient care. MTM is typically documented...

    Authors: Margie E. Snyder, Heather Jaynes, Stephanie A. Gernant, Julie DiIulio, Laura G. Militello, William R. Doucette, Omolola A. Adeoye and Alissa L. Russ

    Citation: BMC Medical Informatics and Decision Making 2019 19:135

    Content type: Research article

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  13. A 2016 study standardized the definition of stillbirths. It estimated the rate as a proportion of total births. A 2015 paper addressed the problem of disability-adjusted life-years (DALY) for stillbirths. Ther...

    Authors: Chander Kant

    Citation: BMC Medical Informatics and Decision Making 2019 19:133

    Content type: Debate

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  14. Patient decision aids (PDAs) can support the treatment decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision-making (SDM) approach makin...

    Authors: Anshu Ankolekar, Ben G. L. Vanneste, Esther Bloemen-van Gurp, Joep G. van Roermund, Evert J. van Limbergen, Kees van de Beek, Tom Marcelissen, Victor Zambon, Matthias Oelke, Andre Dekker, Cheryl Roumen, Philippe Lambin, Adriana Berlanga and Rianne Fijten

    Citation: BMC Medical Informatics and Decision Making 2019 19:130

    Content type: Technical advance

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  15. Decisional conflict is associated with decision quality and may affect decision outcomes. In the health sciences literature, the Decisional Conflict Scale is widely used to measure decisional conflict, yet lim...

    Authors: Rachel A. Pozzar, Donna L. Berry and Fangxin Hong

    Citation: BMC Medical Informatics and Decision Making 2019 19:124

    Content type: Research article

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  16. The autoverification system for coagulation consists of a series of rules that allow normal data to be released without manual verification. With new advances in medical informatics, the laboratory information...

    Authors: Zhongqing Wang, Cheng Peng, Hui Kang, Xia Fan, Runqing Mu, Liping Zhou, Miao He and Bo Qu

    Citation: BMC Medical Informatics and Decision Making 2019 19:123

    Content type: Research article

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  17. Many healthcare databases have been routinely collected over the past decades, to support clinical practice and administrative services. However, their secondary use for research is often hindered by restricte...

    Authors: João Rafael Almeida, Rosa Gini, Giuseppe Roberto, Peter Rijnbeek and José Luís Oliveira

    Citation: BMC Medical Informatics and Decision Making 2019 19:121

    Content type: Software

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  18. Most of readmission prediction models are implemented at the time of patient discharge. However, interventions which include an early in-hospital component are critical in reducing readmissions and improving p...

    Authors: Natalie Flaks-Manov, Maxim Topaz, Moshe Hoshen, Ran D. Balicer and Efrat Shadmi

    Citation: BMC Medical Informatics and Decision Making 2019 19:118

    Content type: Research article

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  19. Data mining tools have been increasingly used in health research, with the promise of accelerating discoveries. Lift is a standard association metric in the data mining community. However, health researchers s...

    Authors: Khanh Vu, Rebecca A. Clark, Colin Bellinger, Graham Erickson, Alvaro Osornio-Vargas, Osmar R. Zaïane and Yan Yuan

    Citation: BMC Medical Informatics and Decision Making 2019 19:112

    Content type: Research article

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  20. Cardiovascular risk management (CVRM) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease. Computerized decision support systems (CDSS) ena...

    Authors: T. Katrien J. Groenhof, Folkert W. Asselbergs, Rolf H. H. Groenwold, Diederick E. Grobbee, Frank L. J. Visseren and Michiel L. Bots

    Citation: BMC Medical Informatics and Decision Making 2019 19:108

    Content type: Research article

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  21. Evidence-Based Medicine (EBM) is the process of systematically locating, searching, evaluating, and using contemporaneous research findings as the basis for clinical decision making. The systematic review show...

    Authors: Teshager Worku, Meron Yeshitila, Tilaye Feto, Shiferaw Leta, Frehiwot Mesfin and Haymanot Mezmur

    Citation: BMC Medical Informatics and Decision Making 2019 19:107

    Content type: Research article

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  22. Inappropriate prescribing of psychotropics is a persistent and prevalent problem in nursing homes. The present study compared inappropriate prescribing of psychotropics in nursing homes 16 years apart with pre...

    Authors: Jan Schjøtt and Jörg Aßmus

    Citation: BMC Medical Informatics and Decision Making 2019 19:102

    Content type: Research article

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  23. Multiple predictive scores using Electronic Patient Record data have been developed for hospitalised patients at risk of clinical deterioration. Methods used to select patient centred variables for inclusion i...

    Authors: James Malycha, Timothy Bonnici, David A. Clifton, Guy Ludbrook, J. Duncan Young and Peter J. Watkinson

    Citation: BMC Medical Informatics and Decision Making 2019 19:98

    Content type: Research article

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  24. Mobile health (MH) technologies including clinical decision support systems (CDSS) provide an efficient method for patient monitoring and treatment. A mobile CDSS is based on real-time sensor data and historic...

    Authors: Shaker El-Sappagh, Farman Ali, Abdeltawab Hendawi, Jun-Hyeog Jang and Kyung-Sup Kwak

    Citation: BMC Medical Informatics and Decision Making 2019 19:97

    Content type: Research article

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  25. Although fecal hemoglobin concentration (f-Hb) was highly associated with the risk of colorectal neoplasms, current studies on this subject are hampered by skewedness of the data and the ordinal property of f-...

    Authors: Szu-Min Peng, Han-Mo Chiu, Hsiao-Hsuan Jen, Chen-Yang Hsu, Sam Li-Sheng Chen, Sherry Yueh-Hsia Chiu, Amy Ming-Fang Yen, Jean Ching-Yuan Fann, Yi-Chia Lee and Hsiu-Hsi Chen

    Citation: BMC Medical Informatics and Decision Making 2019 19:94

    Content type: Research article

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  26. While early diagnostic decision support systems were built around knowledge bases, more recent systems employ machine learning to consume large amounts of health data. We argue curated knowledge bases will rem...

    Authors: Lars Müller, Rashmi Gangadharaiah, Simone C. Klein, James Perry, Greg Bernstein, David Nurkse, Dustin Wailes, Rishi Graham, Robert El-Kareh, Sanjay Mehta, Staal A. Vinterbo and Eliah Aronoff-Spencer

    Citation: BMC Medical Informatics and Decision Making 2019 19:93

    Content type: Database

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  27. Maintaining physical fitness is a crucial component of the therapeutic process for patients with cardiovascular disease (CVD). Despite the known importance of being physically active, patient adherence to exer...

    Authors: Kristina Livitckaia, Vassilis Koutkias, Evangelia Kouidi, Mark van Gils, Nikolaos Maglaveras and Ioanna Chouvarda

    Citation: BMC Medical Informatics and Decision Making 2019 19:92

    Content type: Research article

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  28. Many clinical concepts are standardized under a categorical and hierarchical taxonomy such as ICD-10, ATC, etc. These taxonomic clinical concepts provide insight into semantic meaning and similarity among clin...

    Authors: Zheng Jia, Xudong Lu, Huilong Duan and Haomin Li

    Citation: BMC Medical Informatics and Decision Making 2019 19:91

    Content type: Research article

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  29. Shared decision making is associated with improved patient outcomes in radiation oncology. Our study aimed to capture how shared decision-making practices–namely, communicating potential harms and benefits and...

    Authors: Laurie Pilote, Luc Côté, Selma Chipenda Dansokho, Émilie Brouillard, Anik M. C. Giguère, France Légaré, Roland Grad and Holly O. Witteman

    Citation: BMC Medical Informatics and Decision Making 2019 19:84

    Content type: Research article

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  30. While doctors should analyze a large amount of electronic medical record (EMR) data to conduct clinical research, the analyzing process requires information technology (IT) skills, which is difficult for most ...

    Authors: Tong Ruan, Yueqi Huang, Xuli Liu, Yuhang Xia and Ju Gao

    Citation: BMC Medical Informatics and Decision Making 2019 19:82

    Content type: Research article

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  31. Coronary artery disease (CAD), a leading cause of mortality, affects patient health-related quality of life (HRQoL). Elective percutaneous coronary interventions (ePCIs) are usually performed to improve HRQoL ...

    Authors: Rabah M. Al abdi, Hussam Alshraideh, Heba H. Hijazi, Mohamad Jarrah and Mohammad S. Alyahya

    Citation: BMC Medical Informatics and Decision Making 2019 19:46

    Content type: Research article

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  32. Social isolation is an important social determinant that impacts health outcomes and mortality among patients. The National Academy of Medicine recently recommended that social isolation be documented in elect...

    Authors: Vivienne J Zhu, Leslie A Lenert, Brian E Bunnell, Jihad S Obeid, Melanie Jefferson and Chanita Hughes Halbert

    Citation: BMC Medical Informatics and Decision Making 2019 19:43

    Content type: Research article

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    The Correction to this article has been published in BMC Medical Informatics and Decision Making 2019 19:89

  33. Efficient planning of hospital bed usage is a necessary condition to minimize the hospital costs. In the presented work we deal with the problem of occupancy forecasting in the scale of several months, with a ...

    Authors: Ekaterina Kutafina, Istvan Bechtold, Klaus Kabino and Stephan M. Jonas

    Citation: BMC Medical Informatics and Decision Making 2019 19:39

    Content type: Research article

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  34. When outbreak detection algorithms (ODAs) are considered individually, the task of outbreak detection can be seen as a classification problem and the ODA as a sensor providing a binary decision (outbreak yes o...

    Authors: Gaëtan Texier, Rodrigue S. Allodji, Loty Diop, Jean-Baptiste Meynard, Liliane Pellegrin and Hervé Chaudet

    Citation: BMC Medical Informatics and Decision Making 2019 19:38

    Content type: Research article

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    The Correction to this article has been published in BMC Medical Informatics and Decision Making 2019 19:81

  35. Information about effects of treatments based on unsystematic reviews of research evidence may be misleading. However, finding trustworthy information about the effects of treatments based on systematic review...

    Authors: Andrew D. Oxman and Elizabeth J. Paulsen

    Citation: BMC Medical Informatics and Decision Making 2019 19:35

    Content type: Research article

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  36. Existing resources to assist the diagnosis of rare diseases are usually curated from the literature that can be limited for clinical use. It often takes substantial effort before the suspicion of a rare diseas...

    Authors: Feichen Shen, Yiqing Zhao, Liwei Wang, Majid Rastegar Mojarad, Yanshan Wang, Sijia Liu and Hongfang Liu

    Citation: BMC Medical Informatics and Decision Making 2019 19:32

    Content type: Research article

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  37. To improve medication surveillance and provide pharmacotherapeutic support in University Hospitals Leuven, a back-office clinical service, called “Check of Medication Appropriateness” (CMA), was developed, con...

    Authors: Charlotte Quintens, Thomas De Rijdt, Tine Van Nieuwenhuyse, Steven Simoens, Willy E. Peetermans, Bart Van den Bosch, Minne Casteels and Isabel Spriet

    Citation: BMC Medical Informatics and Decision Making 2019 19:29

    Content type: Research article

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  38. Although osteoporosis is an easily diagnosed and treatable condition, many individuals remain untreated. Clinical decision support systems might increase appropriate treatment of osteoporosis. We designed the ...

    Authors: Haukur T. Gudmundsson, Karen E. Hansen, Bjarni V. Halldorsson, Bjorn R. Ludviksson and Bjorn Gudbjornsson

    Citation: BMC Medical Informatics and Decision Making 2019 19:27

    Content type: Research article

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  39. The implementation of new medical interventions into routine care involves healthcare professionals adopting new clinical behaviours and changing existing ones. Whilst theory-based approaches can help understa...

    Authors: Sebastian Potthoff, Justin Presseau, Falko F. Sniehotta, Matthew Breckons, Amy Rylance and Leah Avery

    Citation: BMC Medical Informatics and Decision Making 2019 19:23

    Content type: Research article

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  40. Regulatory approval of next generation sequencing (NGS) by the FDA is advancing the use of genomic-based precision medicine for the therapeutic management of cancer as standard care. Recent FDA guidance for th...

    Authors: Grace K. Dy, Mary K. Nesline, Antonios Papanicolau-Sengos, Paul DePietro, Charles M. LeVea, Amy Early, Hongbin Chen, Anne Grand’Maison, Patrick Boland, Marc S. Ernstoff, Stephen Edge, Stacey Akers, Mateusz Opyrchal, Gurkamal Chatta, Kunle Odunsi, Sarabjot Pabla…

    Citation: BMC Medical Informatics and Decision Making 2019 19:14

    Content type: Research article

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  41. Joint models (JM) have emerged as a promising statistical framework to concurrently analyse survival data and multiple longitudinal responses. This is particularly relevant in clinical studies where the goal i...

    Authors: Hugo Loureiro, Eunice Carrasquinha, Irina Alho, Arlindo R. Ferreira, Luís Costa, Alexandra M. Carvalho and Susana Vinga

    Citation: BMC Medical Informatics and Decision Making 2019 19:13

    Content type: Research article

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  42. This paper suggests a method to assess the extent to which ultra-short Heart Rate Variability (HRV) features (less than 5 min) can be considered as valid surrogates of short HRV features (nominally 5 min). Sho...

    Authors: R. Castaldo, L. Montesinos, P. Melillo, C. James and L. Pecchia

    Citation: BMC Medical Informatics and Decision Making 2019 19:12

    Content type: Research article

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  43. Colorectal cancer (CRC) screening has shown to reduce incidence and mortality rates, and therefore is widely recommended for people above 50 years-old. However, despite the implementation of population-based s...

    Authors: Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Alezandra Torres-Castaño, Vanesa Ramos-Garcia, Yolanda Alvarez-Perez, Nerea Gonzalez-Hernandez, Andrea Buron, Michael Pignone and Pedro Serrano-Aguilar

    Citation: BMC Medical Informatics and Decision Making 2019 19:8

    Content type: Research article

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  44. Machine-learning classifiers mostly offer good predictive performance and are increasingly used to support shared decision-making in clinical practice. Focusing on performance and practicability, this study ev...

    Authors: Manuel Huber, Christoph Kurz and Reiner Leidl

    Citation: BMC Medical Informatics and Decision Making 2019 19:3

    Content type: Research article

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  45. The Cancer of the Prostate Risk Assessment (CAPRA) score was designed and validated several times to predict the biochemical recurrence-free survival after a radical prostatectomy. Our objectives were, first, ...

    Authors: Marine Lorent, Haïfa Maalmi, Philippe Tessier, Stéphane Supiot, Etienne Dantan and Yohann Foucher

    Citation: BMC Medical Informatics and Decision Making 2019 19:2

    Content type: Research article

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  46. Breast cancer chemoprevention can reduce breast cancer incidence in high-risk women; however, chemoprevention is underutilized in the primary care setting. We conducted a pilot study of decision support tools ...

    Authors: Rita Kukafka, Jiaqi Fang, Alejandro Vanegas, Thomas Silverman and Katherine D. Crew

    Citation: BMC Medical Informatics and Decision Making 2018 18:134

    Content type: Research article

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  47. Decision-making about palliative care for metastatic colorectal cancer (mCRC) consists of many different treatment-related decisions, and there generally is no best treatment option. Decision support systems (...

    Authors: Ellen G. Engelhardt, Dóra Révész, Hans J. Tamminga, Cornelis J. A. Punt, Miriam Koopman, Bregje D. Onwuteaka-Philipsen, Ewout W. Steyerberg, Henrica C. W. de Vet and Veerle M. H. Coupé

    Citation: BMC Medical Informatics and Decision Making 2018 18:132

    Content type: Research article

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  48. As of 2014, stroke is the fourth leading cause of death in Japan. Predicting a future diagnosis of stroke would better enable proactive forms of healthcare measures to be taken. We aim to predict a diagnosis o...

    Authors: Douglas Teoh

    Citation: BMC Medical Informatics and Decision Making 2018 18:127

    Content type: Technical advance

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  49. Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the...

    Authors: Erik Berglund, Ragnar Westerling, Johan Sundström and Per Lytsy

    Citation: BMC Medical Informatics and Decision Making 2018 18:106

    Content type: Research article

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  50. To identify publicly available internet resources and assess their likelihood to support women making informed decisions about, and between, fertility preservation procedures before starting their cancer treat...

    Authors: N. Mahmoodi, H. L. Bekker, N. V. King, J. Hughes and G. L. Jones

    Citation: BMC Medical Informatics and Decision Making 2018 18:104

    Content type: Research article

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